Intravitreal triamcinolone acetonide for exudative age related macular degeneration

• Published in: British journal of ophthalmology Vol. 87; no. 4; pp. 462 - 468
• Main Authors: Jonas, J B, Kreissig, I, Hugger, P, Sauder, G, Panda-Jonas, S, Degenring, R
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.04.2003; BMJ; BMJ Publishing Group LTD; Copyright 2003 British Journal of Ophthalmology
• Subjects: Age; age related macular degeneration; Aged; Aged, 80 and over; Biological and medical sciences; Cataract - chemically induced; Cataracts; Clinical Science; Diabetes; Diabetic retinopathy; Eye; Eye surgery; Female; Glaucoma; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Humans; Hypertension; Injections - methods; intraocular pressure; Intraocular Pressure - drug effects; Macular degeneration; Macular Degeneration - drug therapy; Male; Medical sciences; Middle Aged; Occult sciences; Older people; Pharmacology. Drug treatments; Photodynamic therapy; Prospective Studies; steroid response; Studies; Surgery; Time Factors; triamcinolone acetonide; Triamcinolone Acetonide - administration & dosage; Triamcinolone Acetonide - adverse effects; Visual Acuity - drug effects; Human; Macular degeneration; Eye disease; Chemotherapy; Treatment; Vitreous body; Maculopathy; Injection; Age
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.87.4.462

Aim: To evaluate the effect of intravitreal triamcinolone acetonide on the visual acuity of patients with exudative age related macular degeneration, to assess the duration of a possible effect, and to evaluate clinical side effects of the treatment. Methods: The study included 67 patients (71 eyes) who presented with exudative age related macular degeneration of predominantly or total occult type (n = 68) or classic type (n = 3), and who received once, or repeatedly, an intravitreal injection of 25 mg of crystalline triamcinolone acetonide. Mean follow up time was 7.46 (SD 3.54) months (range 3.1–19.57 months). Results: Visual acuity increased significantly (p <0.001) from 0.16 (0.11) to a mean maximum of 0.23 (0.17). Postoperative visual acuity was highest 1–3 months after the injection. 47 (66.2%) eyes gained in maximal visual acuity and 11 (15.5%) eyes lost in visual acuity. Intraocular pressure increased significantly (p <0.001) from 15.1 (3.1) mm Hg at baseline to a maximal value of 23.0 (8.25) mm Hg. At the end of follow up, intraocular pressure again decreased significantly (p<0.001) to 16.8 (4.9) mm Hg. No cases of postoperative infectious endophthalmitis, rhegmatogenous retinal detachment, or proliferative vitreoretinopathy occurred. Owing to a decrease in visual acuity after an initial increase, six patients received a second intravitreal triamcinolone acetonide injection after which visual acuity increased again in three eyes. Conclusions: Intravitreal injection of 25 mg of crystalline triamcinolone acetonide merits further study for the treatment of exudative age related macular degeneration.